There are several possible causes of back pain: first, myofasciitis, myofasciitis often starts with pain in the medial scapula, which can radiate to the ipsilateral shoulder and upper limbs, with symptoms of soreness and weakness, especially during exertion and pressure at night when sleeping. Second, gallbladder and heart diseases, when the gallbladder has cholecystitis, gallbladder stones, there can be pain in the right side of the back bone, if the heart attack or angina, there can be pain in the left side of the back bone, early examination of the heart and gallbladder to make a diagnosis. Third, lung diseases, when there is a tumor or inflammation in the lung, pain at the back bone can also appear, and CT examination of the lung should be performed for diagnosis and treatment. Fourth, scapula and rib diseases, when there is a tumor in the scapula and ribs, pain at the back bone can also occur, CT and ECT examination of the ribs and scapula should be performed for diagnosis and treatment.